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Lung Cancer

Shadow on chest xray

12/22/2009

Question:

I recently had a chest xray for heart palpitations ( heart is ok, just anxiety) but the radiologist saw a shadow on the lung and recommended a repeat in 4 weeks. My doctor said the wait was because the shadow was not suspicious. It was probably a remnant from an infection as I just got over a sore throat, fever and cough or an artefact. My blood count was slightly out like someone who was just ill. I have never smoked, healthy, fit 43 year old female. Are there different levels of suspicion of xray shadows? Are lung cancers identifiable on an xray? I am very worried and anxious.

Answer:

A lung opacity (marking) on chest xray is not specific for any process. While it can be a cancer, most are benign processes such as infection. Since you had a recent illness, associating this with an infection is reasonable. The key is that the xray is repeated in the near future. The concern about cancer is understandable. However, you are not a smoker. Around 90% of lung cancer occurs in smokers or former smokers. Thus, your risk is relatively low. It sounds like your doctor is approaching this reasonably. If the spot persists, then a CT chest may be considered. If there is concern that an abnormality persists, then you might consider seeing a lung expert, either a pulmonologist or a general thoracic surgeon who has expertise in minimally-invasive surgery.

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Response by:

Michael F Reed, MD Michael F Reed, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati